Signs and Symptoms of Severe Iron Deficiency and Anemia

by
DR. NANCY L. MOYER Aug. 14, 2017

Dr. Nancy L. Moyer

Based in Northern Minnesota and the Turks and Caicos Islands, Dr. Nancy Moyer has been combining her knowledge and experience as a physician with her love of writing to create health-related articles since 2008. She has written for medical and nonmedical readers and is a member of the American Medical Writers Association.

Fatigue is a sign of iron deficiency.
Photo Credit: James Woodson/DigitalVision/Getty Images

Iron is an essential mineral your body needs to produce energy, store oxygen and maintain other vital body functions. When you are deficient in iron, your body cannot make enough red blood cells and you become anemic. Because iron is important for so many of your body's functions, severe iron deficiency can lead to a wide array of signs and symptoms. For instance, you may notice changes in your energy level, exercise tolerance, heartbeat and thought processes. Severe iron deficiency can also cause changes in your skin, hair, nails and even cravings.

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General Signs and Symptoms

Red blood cells need iron to transport oxygen throughout the body, and muscles need iron to store oxygen. When you are iron-deficient, fewer red blood cells are produced, causing anemia. In anemia, your body does not get enough oxygen, which lowers your energy and makes you tired. If you become severely iron-deficient, your muscles themselves become low in iron and oxygen stores, and this -- combined with low oxygen from anemia -- causes poor exercise tolerance and weakness. In addition, you may not tolerate the cold very well because iron is important for regulating your body temperature.

Cardiovascular Signs and Symptoms

When you are anemic from iron deficiency, your blood cannot carry enough oxygen to meet the needs of your tissues and cells. Your heart tries to make up for the lack of oxygen by pumping faster and harder, which may cause skipped beats, a rapid heartbeat or dizziness upon standing. These symptoms may be accompanied by a pounding or whooshing sound in the ears. In addition, you may experience shortness of breath and chest pain with minimal activity or at rest, especially if you already have heart disease. These symptoms could mean your heart is not getting enough oxygen, and these symptoms require immediate medical attention.

Skin-Related Signs

Because your body requires iron to maintain healthy cells, severe iron deficiency may be noticeable in your skin, mouth, hair and nails. The red color of oxygen-carrying red blood cells impacts your skin color, so anemia due to severe iron deficiency may cause pale skin, palms and nail beds. When the iron stores in your body are depleted, your tongue may become smooth and sore and you may develop sores at the corners of your mouth. You may also experience hair loss, and your nails may become brittle and spoon-shaped when you are iron-deficient.

Nervous System Signs and Symptoms

Iron and the oxygen it carries are important for proper brain function. Reduced iron stores resulting in anemia and inadequate oxygen delivery to your brain may impair thought processes. For example, you might have difficulty concentrating or be more forgetful. Inadequate iron stores in the brain can also cause restless leg syndrome. An unusual symptom of severe iron deficiency and anemia is pica, which is a compulsive craving for nonfood items such as clay or starch. Craving ice is specifically associated with iron deficiency.

When to Seek Medical Attention

If you have any of the signs and symptoms of iron deficiency or anemia, you should be evaluated by your doctor. Although often easily treated, severe iron deficiency and anemia can be life-threatening. Symptoms that require immediate medical attention include shortness of breath and chest pain with minimal or no activity.